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This book provides a clear and well-researched view of the impact of trauma in adulthood on the individual's psyche, along with an impassioned plea for technical approaches that follow from this understanding. Boulanger's primary theoretical perspective is a relational one; she also integrates aspects of object relations and Lacanian theory into her understanding of adult-onset trauma.
In the first section of her book, Boulanger presents an argument for the distinction between the psychological impact of massive trauma on adults and children and offers a way of conceptualizing this in psychoanalytic terms. For children, trauma provokes affects that overwhelm developing ego capacities and is defended against in a variety of ways. Boulanger focuses exclusively on the dissociative defenses and contends that trauma becomes embodied in children within different self-states that eventually become integral, if unintegrated, dimensions of their personality.
Adults, on the other hand, understand more fully the nature of the danger they confront and Boulanger describes how they can become numb, overwhelmed by terror, their capacity for immediate self-reflection and integration disrupted. She references recent studies undertaken by neurobiologists that might explain the range of